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Overview. By definition, menopause is the absence of menstrual
periods for twelve months. The period of time (which may be
several years in duration) before menopause is known
as the perimenopause. After twelve months without
a period you have “gone through menopause”. For the rest of
your life you are considered to be in a condition called postmenopause.
Menopause is a normal part of life. Perimenopause can begin
after normal childbearing years. It may begin in your 30s
to your 50s. Each woman is different, affected by a wide variety
of factors such as genetic issues (when did your mother begin
to go through “the change”?) and lifestyle issues (general
health, exercise, smoking). When your ovaries stop making
enough of the female hormones estrogen and progesterone, you
begin this natural biological process. Menopause is surgically
induced when the ovaries are removed via a surgical operation.
Once the ovaries are removed, either at the time of a hysterectomy
or at a later date in a separate procedure called an oophorectomy,
then menopausal symptoms will begin. The source of estrogen,
the ovaries, has been eliminated.
Symptoms. No two women will experience menopause in the same
way. Again such factors as overall health, diet and nutrition,
stress, exercise and consumption of alcohol and smoking will
have an impact on the symptoms of menopause that you experience.
Among the symptoms that can occur are:
| Irregular Periods |
Menstrual cycle may become longer or shorter, lighter
or
heavier. This unpredictability may be your first clue
that
menopause is approaching. Note that an egg is still being
produced; you may still become pregnant. |
| Vaginal Dryness |
With lower estrogen levels, the tissues lining the vagina
may become drier, thinner and less elastic. Burning and
itching may occur. Sexual intercourse may become more
painful; appropriate lubricants may help this situation. |
| Urinary Difficulties |
Again, the lining of the uretha experiences the same
dryness
and inelasticity as the vagina. Your may have more UTI’s.
Urinary incontinence or urgency may also occur. |
| Hot Flashes |
With lower estrogen levels, your blood vessels may expand
rapidly, causing your skin temperature to rise suddenly.
This
can occur in wave-like sensations from your chest to your
neck and head. You may sweat, feel dizzy, and then become
chilled. Night sweats or sleeping problems may be a result
of these night flashes. |
| Emotional Effects |
Irritability, anxiety, stress and depression can occur.
Part of this may be traced to hormone levels, while part
of this may be related to lack of sleep issues. Other
life issues such as illness/death of a parent, children
leaving/returning home, and retirement can have a direct
impact on your emotional state. |
Additional related health problems that can occur are:
| Osteoporosis |
Bone material is created and broken down/lost every
day.
Estrogen helps control bone loss. With lower estrogen
levels
during menopause, more bone is lost then is created. This
can make the bones weak and more easily broken |
| Heart Disease |
Part of this is age, but part may be related to overall
body
chemical changes. High blood pressure, weight gain and
hardening of the arteries can create cardiovascular issues. |
Treatment. There are a wide variety of treatment options
available. Your provider will discuss these with you and together
a plan will be developed. This plan will address the symptoms
you are experiencing. Hormone therapy may include estrogen
or progesterone therapy. Other medicines with known clinical
impact include low-dose antidepressants, and Gabapentin or
Clonidine (for relief from hot flashes). Vaginal estrogen
can be used to
address some of the vaginal/urinary symptoms. There are other
dietary supplements such as black cohosh, soy and red clover
and Vitamin E that have mixed scientific evidence as to their
effectiveness in reducing the symptoms of menopause. There
are even more exotic supplements that have even more questionable
impact on treating these symptoms.
There are clinically approved medicines for osteoporosis
and heart disease that your provider will discuss with you.
|
